Organization
MARYLAND INSTITUTE FOR INDIVIDUAL & FAMILY THERAPY
Active
Other names
Maryland Institute
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID P FAGO PH.D. (DIRECTOR)
(301) 277-3250
Entity
Organization
Contact information
Practice address
7307 BALTIMORE AVE, SUITE 208, COLLEGE PARK, MD 20740-3231
(301) 277-3250
(301) 927-8052
Mailing address
7307 BALTIMORE AVE, SUITE 208, COLLEGE PARK, MD 20740-3231
(301) 277-3250
(301) 927-8052
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
01730
MD
Other
Enumeration date
01/11/2008
Last updated
01/11/2008
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